Les inhibiteurs de la voie JAK-STAT : Un nouveau jackpot pour la dermatologie
Résumé
La dermatologie passe par une phase d’explosion de nouveaux traitements ciblant la voie Janus kinase (JAK)/signal transducteur et activateur de transcription (STAT). Cette voie joue un rôle déterminant dans la régulation des cellules immunitaires, en particulier la polarisation des lymphocytes T auxiliaires par le biais des récepteurs de cytokines. Déjà, un certain nombre de traitements dermatologiques ciblent l’environnement extracellulaire en diminuant les niveaux de cytokines inflammatoires libres telles que les interleukines (IL-17, IL-23) et le facteur de nécrose tumorale alpha (TNFα), ou en inhibant les récepteurs de cytokines tels que les récepteurs IL-17 ou les récepteurs IL-4. Ces traitements sont généralement constitués de grosses molécules ressemblant à des anticorps, dénommées agents biologiques, qui doivent être administrées par injection. Les nouveaux traitements, sous forme de petites molécules qui inhibent les kinases intracellulaires, peuvent être administrés par voie orale ou topique. Ce sont les inhibiteurs de JAK (iJAK). Depuis plusieurs années, ils sont utilisés en rhumatologie (tofacitinib), en hémato-oncologie (ruxolitinib), en médecine vétérinaire (oclacitinib) et en recherche fondamentale. Ils s’imposent de plus en plus en dermatologie.
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